The objective of the study to evaluate whether a bolus administration of intravenous
lidocaine decreases postoperative pain and represents an opioid-minimizing strategy after
abdominal hysterectomy compared with placebo.

Random allocation of patients in two groups; Tap block group (T group) and control group (C
group). All patients will receive standard general anesthesia and postoperative pain
management. The TAP group patient will receive ultrasound guided (US) TAP block with 20 cc of
0.25% of bupivacaine and control group will receive 20cc of normal saline. TAP block in both
groups will be performed with US guidance and the study drug will be injected after complete
visualization of the needle tip between the internal oblique and the transversus abdominis
muscles.
Venous blood samples (5 ml for each time) for metabolic and stress hormones, including, Serum
cortisol and nor-epinephrine will be collected before anesthesia at the time of cannulation
(T1),60 minutes after incision(T2), 6hrs (T3)and 12 h (T4) after the surgery.
Postoperatively patient will be put on patient controlled intravenous infusion of nalbuphine

The investigators hypothesis is that patient controlled local anesthetics administered
intraabdominally are more efficacious compared to continuous infusion in reducing
postoperative pain and morphine consumption.

Interventional studies are often prospective and are specifically tailored to evaluate direct impacts of treatment or preventive measures on disease.

Observational studies are often retrospective and are used to assess potential causation in exposure-outcome relationships and therefore influence preventive methods.

Expanded access is a means by which manufacturers make investigational new drugs available, under certain circumstances, to treat a patient(s) with a serious disease or condition who cannot participate in a controlled clinical trial.

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.

Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.

Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.

Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

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